Care by Midwives, Obstetricians, and Dietitians for Pregnant Women Following a Strict Plant-Based Diet: A Cross-Sectional Study.

Deidre Meulenbroeks,Jessica Gubbels,Isabel Versmissen,Hubertina Scheepers,Nanique Prins,Daisy Jonkers

doi:10.3390/nu13072394

Abstract

With an growing number of people on a strict plant-based diet, its potential effect on pregnancy and lactation becomes increasingly important. It is, however, unclear how obstetric caregivers currently handle and think about a strict plant-based diet in pregnancy. The aim of the study was therefore to evaluate the self-reported knowledge and advice given by Dutch obstetric caregivers and dietitians when treating pregnant women on a strict plant-based diet. A cross-sectional study was performed by sending an online survey to Dutch midwife practices, obstetricians, and dietitian practices. Descriptive statistics are reported. A total of 121 midwives, 179 obstetricians, and 111 dietitians participated in this study. The majority of midwives (80.2%) and obstetricians (93.9%) considered a strict plant-based diet to be a significant risk factor for nutrient deficiency during pregnancy. Maternal dietary preferences, including a potential strict plant-based diet, were discussed at the first prenatal appointment by 59.5% of midwives and 24.1% of obstetricians. A self-reported lack of knowledge concerning the strict plant-based diet was mentioned by 66.1% of midwives and 75.4% of obstetricians. Obstetric caregivers mostly considered the identification of this dietary habit and subsequent referral to a dietitian or a reliable website as optimal care for pregnant women on the strict plant-based diet. However, only 38.7% of dietitians indicated to have sufficient knowledge to counsel these women. Although obstetric caregivers thought that a strict plant-based diet in pregnancy may lead to increased risks of nutritional deficiencies, the majority report to have insufficient knowledge to provide adequate advice. Only a minority referred these women to dietitians, of whom a minority indicated to have adequate knowledge on this specific diet. These results suggest that current care is suboptimal for an increasing number of pregnant women. Women on a strict plant-based diet could benefit from increased knowledge about this topic among obstetric caregivers and dietitians, as well as from clear guidelines regarding this diet during pregnancy.

Highlights

The popularity of a strict plant-based diet, defined as a diet that consists of fruits, vegetables, grains, legumes, nuts, seeds, herbs, and spices, and excludes all animal products, is increasing in the western world
39.7% and 29.5% of midwives and obstetricians, respectively, stated that a pregnant woman on a strict plant-based diet consulted them in the past year
Our study shows that the majority of midwives, obstetricians, and dietitians in the Netherlands feel that they have insufficient knowledge to adequately counsel and guide pregnant women on a strict plant-based diet

Summary

Introduction

The popularity of a strict plant-based diet, defined as a diet that consists of fruits, vegetables, grains, legumes, nuts, seeds, herbs, and spices, and excludes all animal products (often referred to as a vegan diet), is increasing in the western world. In the Netherlands, the estimated number of vegans is about 150,000 in 2020, which is equivalent to 0.86% of the Dutch population [1]. In Great Britain, around 1.16% of the population is vegan, and numbers quadrupled over the last five years [2]. Research has shown that, in general, women maintain their habitual dietary pattern during pregnancy [6]. Specific figures for this group are lacking, the number of women on a strict plant-based diet during pregnancy and lactation has likely increased, and will continue to rise in the nearby future

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